Self-Managed Surveillance for Breast Cancer-Related Upper Body Issues: A Feasibility and Reliability Study.
Arm
/ anatomy & histology
Breast Neoplasms
/ physiopathology
Confidence Intervals
Feasibility Studies
Female
Humans
Middle Aged
Observer Variation
Organ Size
Patient Selection
Postoperative Care
/ methods
Preoperative Care
/ methods
Prospective Studies
Range of Motion, Articular
Reproducibility of Results
Self-Management
Shoulder Joint
/ physiopathology
Journal
Physical therapy
ISSN: 1538-6724
Titre abrégé: Phys Ther
Pays: United States
ID NLM: 0022623
Informations de publication
Date de publication:
10 03 2020
10 03 2020
Historique:
accepted:
22
09
2019
pubmed:
12
2
2020
medline:
30
4
2020
entrez:
12
2
2020
Statut:
ppublish
Résumé
Early identification of breast cancer-related upper body issues is important to enable timely physical therapist treatment. This study evaluated the feasibility and reliability of women performing self-managed prospective surveillance for upper body issues in the early postoperative phase as part of a hospital-based physical therapy program. This was a prospective, single-site, single-group feasibility and reliability study. Presurgery arm circumference measurements were completed at home and at the hospital by participants and by a physical therapist. Instruction in self-measurement was provided using a video guide. After surgery, all circumference measurements were repeated along with self-assessment and therapist assessment for shoulder flexion and abduction active range of motion. Feasibility was determined by recruitment/retention rates and participant-reported ease of performing self-measurements (1 [very difficult] to 10 [very easy]). Reliability was determined as intrarater reliability, interrater reliability, and agreement. Thirty-three women who were 53.4 (SD = 11.4) years old participated, with recruitment and retention rates of 79% and 94%, respectively. Participant-reported ease of measurement was 8.2 (SD = 2.2) before surgery and 8.0 (SD = 1.9) after surgery. The intrarater reliability and interrater reliability were excellent before surgery (intraclass correlation coefficient [ICC] ≥ 0.94; 95% confidence interval = 0.87-0.97) and after surgery (ICC ≥ 0.91; 95% confidence interval = 0.76-0.96). Agreement between self-assessed and therapist-assessed active shoulder flexion (κ = 0.79) and abduction (κ = 0.71) was good. Further testing is needed using a prospective design with a longer follow-up to determine whether self-managed prospective surveillance and timely treatment can hinder the development of chronic breast cancer-related upper body issues. Self-measured arm circumference and shoulder range of motion are reliable, and their inclusion in a hospital-based program of prospective surveillance for upper body issues seems feasible. This approach may improve early detection and treatment.
Sections du résumé
BACKGROUND
Early identification of breast cancer-related upper body issues is important to enable timely physical therapist treatment.
OBJECTIVE
This study evaluated the feasibility and reliability of women performing self-managed prospective surveillance for upper body issues in the early postoperative phase as part of a hospital-based physical therapy program.
DESIGN
This was a prospective, single-site, single-group feasibility and reliability study.
METHODS
Presurgery arm circumference measurements were completed at home and at the hospital by participants and by a physical therapist. Instruction in self-measurement was provided using a video guide. After surgery, all circumference measurements were repeated along with self-assessment and therapist assessment for shoulder flexion and abduction active range of motion. Feasibility was determined by recruitment/retention rates and participant-reported ease of performing self-measurements (1 [very difficult] to 10 [very easy]). Reliability was determined as intrarater reliability, interrater reliability, and agreement.
RESULTS
Thirty-three women who were 53.4 (SD = 11.4) years old participated, with recruitment and retention rates of 79% and 94%, respectively. Participant-reported ease of measurement was 8.2 (SD = 2.2) before surgery and 8.0 (SD = 1.9) after surgery. The intrarater reliability and interrater reliability were excellent before surgery (intraclass correlation coefficient [ICC] ≥ 0.94; 95% confidence interval = 0.87-0.97) and after surgery (ICC ≥ 0.91; 95% confidence interval = 0.76-0.96). Agreement between self-assessed and therapist-assessed active shoulder flexion (κ = 0.79) and abduction (κ = 0.71) was good.
LIMITATIONS
Further testing is needed using a prospective design with a longer follow-up to determine whether self-managed prospective surveillance and timely treatment can hinder the development of chronic breast cancer-related upper body issues.
CONCLUSIONS
Self-measured arm circumference and shoulder range of motion are reliable, and their inclusion in a hospital-based program of prospective surveillance for upper body issues seems feasible. This approach may improve early detection and treatment.
Identifiants
pubmed: 32043126
pii: 5733065
doi: 10.1093/ptj/pzz181
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
468-476Informations de copyright
© 2020 American Physical Therapy Association.